Rheumatoid Arthritis (RA) is an autoimmune disease with unknown etiology resulting in inflamed joints and the destruction of cartilage or bone. About 0.5% of the adult population is affected by this disease, consisting mainly of women aged forty years or older. The disease also leads to other co-morbidities such as cardiovascular, pulmonary and renal diseases.
Diagnosis relies on the 2010 ACR/EULAC Rheumatoid Arthritis classification Criteria that classifies patients by the distribution of joints with clinical synovitis, results of serology tests duration of symptoms and the presence of acute phase reactants (CRP and ESR). However, these historical laboratory tests used in the classification criteria pose a problem, as they are not specific in the diagnosis of RA.
Another laboratory test commonly used in the diagnosis of RA is the anti-nuclear antibody test for autoantibodies present in the body, However, false positive results can occur in approximately 3-15% of healthy individuals, 10-37% in individuals over 65 years of age and those with viral infections or on certain medications.
Cytokines are a group of proteins responsible for cell signalling and are involved in the immunology and pathophysiology of RA. The two main pro-inflammatory cytokines involved are IL-1and TFNa, while IL-4 and IL-10 have shown potential immunomodualtors via the inhibition of Th1 cell activity by suppressing IFN-γ.
An initial diagnosis for RA can be made based on the presence of these cytokines in the blood.
Balance between pro-inflammatory cytokines is important for patients with RA especially during treatment with biologic response modifiers, such as tumor necrosis factor inhibitors, interleukin-1 blockers, and tocilizumab (Actemra), which decrease the levels of cytokines. Therefore, treatment with these mediations could also be monitored with cytokines. Overall, the specificity and benefits of cytokine testing greatly outweigh those of traditional testing for the diagnosis of RA. Hence, cytokine testing should be adopted as a diagnostic test in the investigation of RA.
Ask your doctor about the Biomarker testing. The biomarker's testing as preventive medicine: a new approach to stay healthy. Biomarkers are useful for:
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